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Background In sub-Saharan Africa, problems of access to relevant and high-quality facility-based statistics hinder the assessment of safe motherhood programs. The objective of this study was to assess the quality of data collected in referral hospitals in Mali and Senegal after the routine information system (RIS) was strengthened. Methods This was a multicenter observational study conducted during the pre-intervention period of a randomized controlled trial (trial QUARITE). The RIS was strengthened based on technical, organizational and behavioral factors. We included all women who gave birth in the 46 referral hospitals from October 1, 2007 to October 30, 2008. The completeness, completion and accuracy rates were monitored every 3 months in each hospital. The cost of investment needed to strengthen the existing RIS was also determined. Results The mean completeness rate ranged from 94 to 97% depending on the study period. The completion and accuracy rates increased during the study period from 72% and 79% to 87% and 93%, respectively (significant differences). The average investment per hospital was less than 1% of state subsidies for public hospitals. Conclusion Strengthening the existing information system has set up an economically and technologically appropriate system for monitoring maternal and perinatal health in Senegal and Mali. We encourage policy makers and researchers from countries with limited resources to invest in RIS to improve and monitor the performance of health systems.

International audience; A few species of shrubs grow with dryland row crops in farmers’ fields throughout the Sahel and can significantly increase crop yield. The presence of shrub roots and litter inputs should have implications for soil nutrient pool sizes but there is limited information on the interactions of these shrubs with microbial communities involved in biogeochemical processes. Therefore, the objective of this study was to determine the microbial composition and functional capacity of soil from the rooting zone of pearl millet (Pennisetum glaucum) grown in the presence or absence of the shrub Piliostigma reticulatum in Senegal. Soil samples were collected from a long-term field study where millet was cultivated alone or intercropped with P. reticulatum with annual incorporation of coppiced shrub residues. Higher nutrient contents and distinct differences in microbial communities (DGGE profiles) were found between soils from beneath the canopy compared to soil outside the influence of shrubs. The catabolic response profile (MicroResp™) showed that the soil microbial community at both shrub and non-shrub sampling locations, metabolized a wide range of substrates. Trehalose that can work as a signaling molecule was more rapidly degraded in the rooting zone of millet growing in the presence of P. reticulatum over millet alone. Urease, arylsulfatase and dehydrogenase activities in the millet root zone soil were higher when intercropped with P. reticulatum which indicates enhanced potential of biogeochemical processes to proceed in the presence of this shrub. It is concluded that the native shrub P. reticulatum promotes a more diverse and active microbial community in the rooting zone of millet and further indicates greater potential to perform decomposition and mineralize nutrients.

Résumé Buts Présenter les caractéristiques épidémiologiques, cliniques et thérapeutiques des fractures de verge dans le service d’urologie-andrologie de l’hôpital général de Grand Yoff de Dakar. Matériels et méthode Il s’agit d’une étude descriptive portant sur 25 cas de fracture de verge pris en charge dans le service d’urologie-andrologie de l’hôpital général de Grand Yoff de Dakar entre janvier 2001 et décembre 2011. Les paramètres suivant ont été étudiés: l’âge, la résidence, les antécédents, les données cliniques, les données de l’exploration chirurgicale et les résultats du traitement. Résultats En dix ans, 25 cas de fractures de verge ont été enregistrés soit une moyenne de 2,5 cas par an. L’âge moyen de survenue était de 36 ans avec des extrêmes de 22 et 60 ans. Les circonstances de survenue sont dominées par les manipulations forcées (52 %) et les rapports sexuels (32 %). La douleur associée à une latérodéviation controlatérale de la verge, une tuméfaction localisée de la verge ou extensive à la région sus-pubienne ou périnéale sont les principaux signes retrouvés. Une prise en charge urgente (délai moyen de prise en charge de deux heures avec des extrêmes de 45 minutes et 48 h) en milieu chirurgical avec réparation des corps caverneux et albuginorraphie a été la règle. Conclusion La fracture de verge est une urgence urologique relativement peu fréquente dans notre contexte. Son diagnostic reste aisé et est essentiellement clinique. Une prise en charge précoce et correcte en milieu chirurgical est garante d’un bon résultat fonctionnel et esthétique.

Background Maternal mortality is still too high in sub-Saharan Africa, particularly in referral hospitals. Solutions exist but their implementation is a great issue in the poor-resources settings. The objective of this study is to assess the effect of the organization of obstetric care services on maternal mortality in referral hospitals in Mali. Methods This is a multicentric observational survey in 22 referral hospitals. Clinical data on 42,929 women delivering in the 22 hospitals within the 2007 to 2008 study period were collected. Organization evaluation was based on explicit criteria defined by an expert committee. The effect of the organization on in-hospital mortality adjusted on individual and institutional characteristics was estimated using multi-level logistic regression models. Results The results show that an optimal organization of obstetric care services based on eight explicit criteria reduced in-hospital maternal mortality by 41% compared with women delivering in a referral hospital with sub-optimal organization defined as non-compliance with at least one of the eight criteria (ORa = 0.59; 95% CI = 0.34–0.92). Furthermore, local policies that improved financial access to emergency obstetric care had a significant impact on maternal outcome. Conclusion Criteria for optimal organization include the management of labor and childbirth by qualified personnel, an organization of human resources that allows timely management of obstetric emergencies, routine use of partography for all patients and availability of guidelines for the management of complications. These conditions could be easily implemented in the context of Mali to reduce in-hospital maternal mortality.

Las fistulas vesicovaginales (FVV) son una complicacion infrecuente de una histerectomia o de una cesarea y su tratamiento esta descrito en varios tratados de ginecologia o urologia. En los paises en vias de desarrollo, las FVV son secundarias a una lesion isquemica en una distocia fetopelvica, a causa de un largo periodo entre el inicio del trabajo de parto y la realizacion de una cesarea. Esto provoca consecuencias desastrosas en terminos de lesiones fisicas y morales. En este articulo se describen la etiopatogenia y el tratamiento quirurgico de las fistulas obstetricas (FO), que representan la mayoria de las FVV. Asimismo, se exponen las demas formas de FVV. La exploracion vaginal es fundamental y debe permitir establecer una clasificacion predictiva de la FVV respecto a la dificultad que encontrara el cirujano y al pronostico. La via de acceso baja esta indicada en el tratamiento de la mayoria de las FO y permite tecnicas de cirugia reconstructiva, como los colgajos de interposicion y de sosten. Es necesario emplear tecnicas apropiadas para anticipar el riesgo de recidiva y de una posible incontinencia de esfuerzo residual, sobre todo si el cuello vesical y la uretra estan implicados en el proceso de formacion de la FVV. La suspension del cuello vesical de la fascia endopelvica o arco tendinoso es la clave de la continencia tras la reparacion de las grandes destrucciones tisulares. Las FO con laceracion del cuello uterino (fistulas yuxtacervicales) se tratan mejor por via mixta para completar la separacion vesicouterina y garantizar la hermeticidad de la reparacion. Las fistulas altas tras histerectomia son de facil acceso con laparoscopia convencional o robotizada. Las complicaciones de esta cirugia son el fracaso de la reparacion y la incontinencia de esfuerzo residual, que resultan frustrantes tanto para la paciente, que tiene grandes expectativas en estas situaciones, como para el cirujano. Las reintervenciones en caso de recidiva se efectuan en un tejido aun mas cicatrizal que en las FVV denominadas «de primera mano». En este articulo se describe tambien un modelo de tratamiento global de la FO en condiciones rurales (el modelo de Tanguieta en Benin).

The aim of this pilot study was to analyze the Hepatitis C Virus (HCV) genotypes circulating in Senegal among Drug User (DUs), using Dried Blood Spots (DBS) as RNA source for molecular assays. Heroin and/or cocaine users (n = 506) were recruited in Dakar from April to July 2011, using a Respondent Driven Sampling (RDS) method. DBS preparation consisted of five drops of whole blood from finger applied to a Whatman paper card. HCV infection was screened by the detection of anti-HCV antibodies, using a rapid immune-chromatographic test. HCV RNA was quantified on anti-HCV positive DBS, using the Abbott RealTime HCV® Genotyping was performed on DBS with detectable viral load with Versant® HCV Genotype 2.0 Assay (LiPA) and Abbott RealTime HCV Genotype II assay®. Among the 506 participants, 120 were tested as positive for anti-HCV antibodies and their samples were analyzed for HCV RNA viral load and genotype. Out of the 120 DBS tested, HCV RNA was detected on 25 (20.8%). The median viral load was 15,058 IU/ml (ranging from 710 to 766,740 IU/ml). All positive DBS were suitable for the genotyping assay, that showed a predominance of genotype 1 (21/25) including 16 genotypes 1a and 5 genotypes 1b. HCV genotype 1 prevails in a DU population in Dakar. DBS could be useful for HCV RNA genotyping, but optimal storage conditions should required avoiding RNA impairment. Acknowledging this limitation, DBS could be a great interest for detecting and genotyping HCV viremic patients. J. Med. Virol. 89:484-488, 2017. © 2015 Wiley Periodicals, Inc.

Objectives. The goal of our study was to investigate the prevalence of prostate cancer in an unselected population of Senegalese men. Patients and Methods. We conducted the study over two years (2008 and 2009) on an unselected population of 572 Senegalese men, aged 35 and older. The following parameters have been investigated: the subject's age, the presence or absence of urination disorders, the family's history of prostate cancer or prostate surgery, the aspects of the prostate on digital rectal examination (DRE), the total PSA level, and the outcomes of the prostate biopsies. Data entry was performed with Epi Info 6 software and was analyzed and recorded using Excel software. We performed mean and frequency calculations. Results. The mean age of our patients was 65.5 years, with extremes of 38 and 93 years. Age groups from 50 to 59 and from 60 to 69 were the most represented. DRE was normal in the age group from 35 to 39, and only one patient in the age group from 40 to 49 had a prostate nodule. PSA level was greater than or equal to 4 ng/mL in 66 cases. A total of 5.4% patients had a PSA level greater than or equal to 10 ng/mL. Only two patients in the age group from 40 to 49 had a PSA level greater than 4 ng/mL. Of the 72 biopsies we performed, prostatic adenocarcinoma was found in 30.6% of the cases. It is the only type of prostate cancer we found in our series. The cases of prostate cancer were mostly observed in the age groups from 60 to 69 and from 70 to 79. No cases were detected for ages younger than 50. DRE gave indications of possible adenocarcinoma in 27.30% cases. Its sensitivity was 27%, while its positive predictive value was estimated at 35%. Of all positive biopsies, 4.5% had a PSA level between 0 and 3.9 ng/mL. In this case, the sensitivity of PSA was 95.5%, and the positive predictive value was 31.8%. High-grade intraepithelial neoplasiae were observed in 21 cases. Conclusion. Prostate cancer is frequent in Senegal, and screening remains the best way for early diagnosis.

Resume Une etude retrospective a ete conduite de janvier 2000 a decembre 2003 pour evaluer la resistance de Mycobacterium tuberculosis aux antituberculeux et ses consequences sur le resultat du traitement. Deux cent deux dossiers-patients sont etudies (âge moyen : 36 ans ; sex-ratio : 1,7). La tuberculose est pulmonaire (85,7 %) ou extrapulmonaire (14,3 %). Le statut VIH est negatif (71,3 %), positif (10,8 %) ou inconnu (17,9 %). Le taux global de guerison est de 60,7 % (61,4 % chez les VIH− ; 46,1 % chez les VIH+), celui des echecs therapeutiques est de 2,7 % (1,1 % chez les VIH− ; 15,4 % chez les VIH+), celui des deces dus a la tuberculose est de 6,3 % (2,3 % chez les VIH− ; 23,1 % chez les VIH+), et le taux des patients perdus de vue est de 30,3 % (35,2 % chez les VIH− ; 14,2 % chez les VIH+). Une hepatotoxicite survenant au cours du traitement est observee dans 14,3 % des cas (guerison : 56,2 % ; echec : 6,2 % ; perdus de vue : 18,8 %). Quatre-vingt-quatre pourcent des patients n’ont jamais recu de traitement antituberculeux (groupe A) versus 15,8 % de patients ayant deja recu un ou plusieurs medicaments antituberculeux (groupe B). Les taux de resistance a l’isoniazide sont de 6,4 % (A) et de 12,5 % (B), a la rifampicine de 1,7 % (A) et 12,5 % (B), a l’ethambutol de 0,5 % (A) et 0 % (B), a la streptomycine de 24,1 % (A) et de 46,8 % (B). Le pourcentage de souches multiresistantes est de 1 % chez les patients non traites auparavant et de 11 % chez ceux ayant deja recu un traitement antituberculeux. Lorsque les patients sont porteurs d’une souche sensible au traitement administre, le taux de guerison est de 64,2 % versus 46,7 % chez les patients dont la souche est resistante a au moins un des traitements administres.

Si definisce «idrocefalo» un disturbo dell’idrodinamica del liquor la cui risultante e una dilatazione attiva delle cavita ventricolari e, spesso, degli spazi subaracnoidei. Entro tale termine, apparentemente banale, vengono compresi e confusi concetti fisiopatologici ancora oggetto di discussione e, in particolare, i concetti di «idrocefalo a pressione normale» e di «idrocefalo cronico dell’adulto». Si tratta di una patologia frequente in ambito neurologico e neurochirurgico; si manifesta a qualsiasi eta e le cause che lo sostengono sono varie, anche se le cause prevalenti sono quelle neoplastiche, infettive e malformative. La diagnosi e prima di tutto clinica. La valutazione diagnostica si basa sulle tecniche di imaging, ma anche sulla valutazione idrodinamica. Il trattamento dell’idrocefalo e esclusivamente chirurgico. Le diverse tecniche, largamente praticate, hanno dimostrato la loro efficacia nella gestione dell’idrocefalo.

Resumen Los quistes epidermoides son lesiones congenitas benignas, de lento crecimiento, que representan el 1% de todos los tumores intracraneales. En un 25% tienen una localizacion intradiploica y excepcionalmente infratentorial. Presentamos un caso clinico poco frecuente de un quiste epidermoide intradiploico gigante infratentorial. El paciente consulto por una diplopia y un sindrome cerebeloso. La tomografia computarizada y la resonancia magnetica mostraron una lesion gigante litica extradural de la fosa posterior de 5,2 cm × 3,8 cm, con realce periferico con el contraste. Utilizamos un abordaje suboccipital retrosigmoideo para realizar una exeresis completa tumoral y una reseccion incompleta capsular, debido a la adherencia de esta al seno lateral. La evolucion posoperatoria fue favorable. Realizamos una revision bibliografica de la literatura y discusion de nuestro caso.

Kangaroo care (KC) is an effective method to care for low birth weight (LBW) newborns, particularly in developing countries. The objective of this study was to estimate the efficacy of this method and its impact on morbidity and mortality of LBW infants admitted to the KC unit of Albert-Royer National Children's Hospital Center (ARNCHC) in Dakar, Senegal.This was a retrospective, single-center study from July 2011 to July 2013. We collected sociodemographic, maternal, and obstetrical data, neonatal characteristics and information during KC (age and weight at inclusion, thermoregulation, feeding, growth, and overall progression). Data were entered and analyzed using SPSS version 9.0.We included 135 newborns, with a female predominance (sex ratio: 0.78). One-third of the mothers (35.5%) were primiparous and only 21.1% had a socioprofessional activity and the majority had a low educational level. The mean gestational age (GA) was 33.08±2.06 weeks of amenorrhea and the mean birth weight 1485±370 g. There were 20 term babies with intrauterine growth restriction (IUGR) (14.8%) and 115 (85.2%) preterm newborns, 83 (72.2%) of whom, showed IUGR. The mean duration of conventional care was 12.3 days (range: 4-27 days) and the main complications were respiratory distress (46.2%), infection (36.9%), and necrotizing enterocolitis (15.1%). At KC admission, the mean post-conceptional age was 34.2±2.46 weeks and the mean weight 1445±319 g (minimum, 700 g). The main complications in KC were infections (20.2%), hypoglycemia (18.5%), and gastro-esophageal reflux disease (16.4%). Only 56.3% of the babies were exclusively breastfed. The mean weight gain during the stay in the KC unit was 15.3±9.08 g/kg/day and the mean weight at discharge was 1761±308 g. Only three episodes of hypothermia were noted. The mean duration in the KC unit was 10.2 days (range: 3-24 days). Five babies died (3.7%): one during KC, one at home, and the three others after readmission to neonatology.Kangaroo care for LBW infants is highly effective in our context. This method should be spread to a large majority of health centers in the country.

Prosthetic teeth size and placement must be in perfect harmony with the bucco-facial structures for a successful and esthetic removable prosthesis. This study aimed to determine among young Senegalese black people facial index estimating maxillary central incisor width and distance between canine points starting from bizygomatic width.621 black Senegalese participated to this transversal study. Measurements were made using anthropometric slide caliper and electronic slide caliper. The comparative analysis was carried out by the test t of Student. The correlative analysis used the chi-square test. The risk of error was fixed at 5%.Positive correlations were found between variables. Distance between canine points was significantly (p = 0.000) correlated to bizygomatic width and central incisor width. Using bizygomatic width, the average dividing factors to estimate central incisor width and distance between canine points were respectively 15.13 and 3.75.Distance between canine points and central incisor width can be given starting from bizygomatic width, as guide of selecting maxillary anterior prosthetic teeth width.

Despite the frequency of hysterectomy, several studies have reported physical and psychological sequelae of this intervention. BUT: To evaluate the consequences of hysterectomy, their level of importance and how patients experience hysterectomy.That is a prospective study of 70 patients who underwent a hysterectomy from January 2009 to June 2011 at Pikine National Hospital. The experience of hysterectomy was determined by the physical and psychosocial felt after surgery.Hysterectomy represented 5.9 % of gynecological surgical activities. The indications were dominated by myoma (57.1%). Hysterectomy was performed abdominally in 78.6% of cases and associated with bilateral salpingo-oophorectomy in 87% of cases. After surgery, new symptoms appeared: hot flushes, night sweats, urinary incontinence and urge incontinence in respectively 65.7%, 54.3%, 7.1% and 11.4% of patients. A proportion of 45.6% of them had resumed sexual activity after 90 days. The fear of pain at the time of intercourse was expressed in 55.7% of cases. A decrease in the frequency of sexual intercourse was found in 54.3% of patients. A drop of pleasure during sex was expressed in 38.6% of patients. Psychological effects were also reported by patients: decreased confidence in 31.4% of patients, feeling of being rejected by her husband in 5.7% of cases, sensation of mutilation in 24.3% of cases.Physical and psychological postoperative impacts of hysterectomy are real. Adequate accompanying measures are necessary, in addition to preoperative preparation, to allow patients to improve the experience of hysterectomy.

The hypothesis tested in this present study was that the ectomycorrhizosphere effect on the bacterial community was not root-growth-dependent. The impacts of ectomycorrhizal infection (Pisolithus albus COI007) and a chemical fertilization to reproduce the fungal effect on root growth were examined on (1) the structure of bacterial community and (2) fluorescent pseudomonad and actinomycete populations in the mycorrhizosphere of Acacia auriculiformis using both culture-independent and culture-dependent methods. A. auriculiformis plants were grown in disinfested soil in pots with or without addition of the ectomycorrhizal fungus or N/P/K fertilization (to reproduce the fungal effect on root growth) for 4 months and then transferred to 20-L pots filled with nondisinfested sandy soil. The fungal and fertilizer applications significantly improved the plant growth after 4-month culture in the disinfested soil. In the nondisinfested cultural substrate, these positive effects on plant growth were maintained. The total soil microbiota was significantly different within the treatments as revealed from DNA analysis [denaturing gradient gel electrophoresis (DGGE)]. The structure of fluorescent pseudomonad populations was also affected by fungal and fertilizer applications. In contrast, no qualitative effect was observed for the actinomycete communities within each treatment, but fungal inoculation significantly decreased the number of actinomycetes compared to the fertilizer application treatment. These results show that the mycorrhizosphere effect is not root-growth-dependent but is mainly due to the presence of the ectomycorrhizal fungus and more particularly to the extramatrical mycelium.

We investigate the impact of the representation of the boundary layer transport in a climate model on the representation of the near surface wind and dust emission, with a focus on the Sahel/Sahara region. We show that the combination of vertical turbulent diffusion with a representation of the thermal cells of the convective boundary layer by a mass flux scheme leads to a more realistic representation of the diurnal cycle of wind in spring, with a maximum near surface wind in the morning. This maximum occurs when the thermal plumes reach the low level jet that forms during the night at a few hundred meters above surface. The horizontal momentum in the jet is transported downward to the surface by compensating subsidences around thermal plumes in typically less than one hour. This leads to a rapid increase of wind speed at surface and therefore of dust emissions owing to the strong non linearity of emission laws. The numerical experiments are performed with a zoomed and nudged configuration of the LMDZ general circulation model, coupled to the emission module of the CHIMERE Chemistry Transport Model, in which winds are relaxed toward that of the ERAI reanalyzes. The new set of parameterizations leads to a strong improvement of the representation of the diurnal cycle of wind when compared to a previous version of LMDZ as well as to the reanalyzes used for nudging themselves. It also reinforces dust emissions in better agreement with observations, but the aerosol optical thickness is still significantly underestimated.

Bending effect on the magnetic anisotropy in 20 nm Co$_{2}$FeAl Heusler thin film grown on Kapton\textregistered{} has been studied by ferromagnetic resonance and glued on curved sample carrier with various radii. The results reported in this letter show that the magnetic anisotropy is drastically changed in this system by bending the thin films. This effect is attributed to the interfacial strain transmission from the substrate to the film and to the magnetoelastic behavior of the Co$_{2}$FeAl film. Moreover two approaches to determine the in-plane magnetostriction coefficient of the film, leading to a value that is close to $\lambda^{CFA}=14\times10^{-6}$, have been proposed., Comment: 4 pages, 4 figures

Resume A travers un cas clinique decrit au Senegal, les auteurs abordent les problemes que pose le comportement d'un psychopathe dans un cadre socioculturel africain. Ils montrent les difficultes d'appartenance et l'angoisse d'exclusion du groupe social. Les familles, pour ⪡reparer⪢ la deviance, font souvent recours aux soins traditionnels dans une grande discretion, avant de s'adresser a l'hopital. Elles parviennent neanmoins, avec l'aide d'une equipe specialisee, a trouver des ressources intrinseques leur permettant de gerer au mieux cette difficulte. La societe, s'auto-protegeant, privilegie le groupe social sur l'individu.

Fifty-eight new isolates were obtained from root nodules of common bean (#Phaseolus vulgaris$) cultivated in soils originating from different agroecological areas in Senegal and Gambia (West Africa). A polyphasic approach including both phenotypic and genotypic techniques was used to study the diversity of the 58 #Rhizobium$ isolates and to determine their taxonomic relationships with reference strains. All the techniques performed, analysis of multilocus enzyme electrophoretic patterns, SDS-PAGE profiles of total cell proteins, PCR-RFLP analysis of the genes encoding 16S rRNA and of the 16S-23S RNA intergenic spacer region (ITS-PCR-RFLP), auxanographic tests using API galleries and nodulation tests lead to the consensus conclusion that the new rhizobial isolates formed two main distinct groups, I and II, belonging to #Rhizobium tropici$ type B and #Rhizobium etli$, respectively. By MLEE #R. etli$ and group II strains showed several related electrophoretic types, evidencing some extent of internal heterogeneity among them. This heterogeneity was confirmed by other techniques (ITS-PCR-RFLP, SDS-PAGE and host-plant-specificity) with the same nine distinct strains of group II showing some differences from the core of group II (54 strains). (Résumé d'auteur)

In Senegal at Nioro experimental station the 15 N 2 isotope dilution technique was used at field conditions for estimating fixation of N 2 in Faidherbia albida, mono cultured and mixed with the reference species, Parkinsonia aculeata. Trenched and nontrenched plots within the plantation were labeled with 15 N 2 - ammonium sulphate containing 2 atom % 15 N excess at the equivalent amount of 20 kg N ha -1. The proportion of fixed N 2 was lower than that previously measured in experiments using Parkia biglobosa as a reference tree species: 20.3% vs. 54.7%. This difference might be due to physiological differences between the two reference species. Significant effect of trenching vs. nontrenching to the labeled area was observed on the percentage of N 2 derived from atmosphere (% Ndfa) of F. albida. The % Ndfa was higher in trenched than in nontrenched labeled area (+ 34.3%). There was no difference however in the amount of N 2 fixed in trenched and nontrenched plots although the estimate in the former (6.70 ...

The intramedullary abscess (I.M.A.) is an uncommon and heavy etiology of intramedullary mass syndrom. Since the first description by HART in 1830, about 82 cases have been reported in literature and in one case, it was associated to H.I.V. infection. The authors report a new case in a 52 years old Senegalese man with per operative diagnosis of I.M.A. and post operative diagnosis of H.I.V. infection. They set up difficulties of pre operative diagnosis, and poor results of treatment in such an association. Also they discuss pathogeny and share Magnetic Resonance Imaging (R.M.I.) studies in management.

A greenhouse experiment was conducted to measure N2 fixation in Pterocarpus erinaceus Poir. and P. lucens Lepr. using both A value and direct isotope dilution techniques. A nonfixing plant, Dialium guineense Willd. served as a reference plant. Seven months after planting, the amount of total N accumulated in all plants was 0.46 and 0.34 g plant−1 for P. erinaceus and P. lucens, respectively. Regardless of the method of calculation, total N fixed in the whole plant was 0.16 g for P. erinaceus. and 0.12 g for P. lucens, and the proportion of nitrogen derived from the atmosphere was in the range of 35%. Thus Pterocarpus species should be considered as leguminous trees with low nitrogen fixation potential.

The infection of Vigna subterranea (formerly Voandzeia subterranea) by Bradyrhizobium strain MAO 113 (isolated from V. subterranea) was examined by light and transmission electron microscopy. Bacteria accumulated on the epidermis close to root hairs, and subsequently entered the latter via infection threads. Most of the steps involved in nodule formation were generally characteristic of determinate nodules, such as those which form on the closely related V. radiata. For example, nodule meristems were induced beneath the root epidermis adjacent to infected root hairs, but prior to infection of the meristem by rhizobia. Moreover, after the infection of some of the meristematic cells by the infection threads, and the release of the rhizobia into membrane-bound vesicles, the infection process ceased and dissemination of the rhizobia was by division of already-infected host cells. However, there were some aspects of this process in V. subterranea which have been more commonly described in indeterminate nodules. These include long infection threads entering a number of cells within the meristems simultaneously and a matrix within infection threads which was strongly labelled with immunogold monoclonal antibodies, MAC236 and MAC265, which recognize epitopes on an intercellular glycoprotein. The MAC236 and MAC265 antibodies also recognized material in the unwalled infection droplets surrounding bacteria which were newly-released from the infection threads. The amount of labelling shown was more characteristic of the long infection threads seen in indeterminate nodules such as pea (Pisum sativum) and Neptunia plena. The structure of mature V. subterranea nodules was similar to that described for other determinate nodules such as Glycine max, Vigna unguiculata and V.radiata, i.e. they were spherical and the infected zone consisted of both infected and uninfected cells. Surrounding the infected tissue was an inner cortex of uninfected cell layers containing the putative components of an oxygen diffusion barrier (including glycoprotein-occluded intercellular spaces), and an outer cortex with cells containing calcium oxalate crystals.

For tree legumes, Faidherbia albida is among those with low symbiotic capability, and for which significant improvement is needed. An experiment was conducted in the greenhouse, using the 15N isotope dilution technique to measure differences in the proportion (%Ndfa) and total N fixed in seven F. albida provenances grown in an Arenosol soil in Senegal. Total dry matter and N yield values were not significantly different among the seven provenances. In contrast, significant variability was measured in N2 fixation, with %Ndfa ranging from 0% in two provenances to 38% in the Kabrousse provenance. Also, total N fixed was highest in Kabrousse, 0.44 g N plant‐1, compared with the 0 to 0.26 g plant‐1 fixed in the other provenances. Based on these results, Kabrouse was selected for further examination in the field, where still higher %Ndfa values were obtained, 54, 58, and 54% at 3, 6, and 15 months after transplanting (MAT), respectively. These are higher than the commonly reported values of %Ndfa for F. albida,...

We report the surgical management of eight vulvar tumors occurred at the waning of female genital mutilation practiced in childhood. Patients were aged 19 to 38 years. It was essentially excision type 2. Surgical excision of the labia minora with a refund without clitoral plasty gave satisfactory aesthetic and functional results. Histological examination of these tumors showed a single cyst containing keratin without inflammatory reaction.

To demonstrate the feasibility of copper IUD insertion following cesarean deliveries and assess its safety.This is a prospective pilot study at Pikine national hospital from February 15 to November 15, 2012. Were evaluated the efficacy, incidence and spectrum of complications and continuation rates.Fifty-nine subjects were enrolled and 46 received an IUD. The average age of patients was 28 years. No patient had previously used IUDs. Forty-four patients (97.5%) were returned to the first follow-up visit at the first month, 41 patients (89.1%) at the second visit and 39 patients (86.9%) at the third visit. The rate of lost sight was 8.7%. Pain and bleeding were reported rarely: 2.3% at the first month, 4.9% at the third month and 7.7% at the sixth month for the bleeding and 6.8% at the first month, 2.4% at the third month and 2% at the sixth month for pain. The rate of expulsion was 2.2%.The insertion of the IUD following cesarean delivery has an acceptable rate of expulsion and no increased rate of adverse effects. This technique should be popularized.

Le concept de ganglion sentinelle (GS) a ete decrit pour la premiere fois en 1994 pour le traitement des cancers du sein [1] afin d’eviter un curage axillaire anatomique (CA) inutile si le GS est negatif. L’objectif de notre etude etait d’evaluer la reproductibilite du reperage preoperatoire des ganglions sentinelles dans le traitement du cancer du sein de petite taille, a partir d’une serie de 6 patientes ayant eu deux lymphoscintigraphies (LS) preoperatoires.

Imperforate hymen is a rare malformation (1/ 1000 female births). It is diagnosed most often during puberty. Early diagnosis of hematocolpos and evacuation is necessary to avoid any consequences. We report a rare case of an imperforate hymen complicated with acute urinary retention, hydronephrosis and renal failure in a 14-year-old girl to emphasize thepossible misdiagnosis and its possible consequences. This is the firstcase we encounter in our unit.

In this paper a unique expression of the anisotropy field induced by any multiaxial stress state in a magnetic thin film and probed by ferromagnetic resonance is derived. This analytical development has been made using the uniaxial equivalent stress concept, for which correspondances between definitions given by different authors in the literature is found. The proposed model for the anisotropy field has been applied to thin films (25 nm) stressed both by piezoelectric actuation (non-equi-biaxial) or by bending tests (uniaxial) and measured with a broadband ferromagnetic resonance technique. The overall exprimental data can be easily plotted on a unique graph from which the magnetostriction coefficient has been estimated.

The residual magnetic uniaxial anisotropy of thin films deposited on flexible substrates was studied to elucidate its main origins. For that purpose, we sputtered 20 nm thick films of Co40Fe40B20 and Ni80Fe20 on Kapton® substrates. After measuring magnetomechanical properties of each system, we have shown that the weak residual anisotropy in the Ni80Fe20 film, compared to that of Co40Fe40B20, is perfectly correlated to its low magnetostriction coefficient. As a consequence, we conclude that this residual anisotropy is undoubtedly due to the unavoidable bending of the system, even if it is invisible with the naked eye (radius of several centimeters).

Magneto-stress coupling has been studied in Co20Fe60B20 thin films of varying thicknesses (10, 20 and 250 nm) deposited onto flexible substrate. It has been investigated by measuring the magnetic resonance under uniaxial (tensile or compressive) applied stresses in situ. The benchmark state, in terms of elastic and magnetic properties, was studied by combining Brillouin light scattering experiments and magnetic resonance experiments on flat samples. The deduced parameters are thickness-independent and close to the ones obtained using rigid substrates. A large uniaxial anisotropy proportional to the applied uniaxial stress is found, which is well fitted by considering an isotropic saturation magnetostriction coefficient. Finally, the angular dependence of the resonance field with in-plane biaxial stresses is probed and explained using a simple analytical model.

A pot experiment was conducted in a greenhouse using the 15N isotope dilution method and two reference plants, Parkia biglobosa and Tamarindus indica to estimate nitrogen fixed in four Acacia species: A raddiana, A. senegal, A. seyal and Faidherbia albida (synonym Acacia albida). For the reference plants, the 15N enrichments in leaves, stems and roots were similar. With the fixing plants, leaves and stems had similar 15N enrichments; they were higher than the 15N enrichment of roots. The amounts of nitrogen fixed at 5 months after planting were similar using either reference plant. Estimates of the percentage of N derived from fixation (%Ndfa) for the above ground parts, in contrast to %Ndfa in roots, were similar to those for the whole plant. However, none of the individual plant parts estimated accurately total N fixed in the whole plant, and excluding the roots resulted in at least 30% underestimation of the amounts of N fixed. Between species, differences in N2 fixation were observed, both for %Ndfa and total N fixed. For %Ndfa, the best were A. seyal (average, 63%) and A. raddiana (average, 62%), being at least twice the %Ndfa in A. senegal and F. albida. Because of its very high N content, A. seyal was clearly the best in total N fixed, fixing 1.62 g N plant−1 compared to an average of 0.48 g N plant−1 for the other Acacia species. Our results show the wide variability existing between Acacia species in terms of both %Ndfa and total N fixed: A. seyal was classified as having a high N2 fixing potential (NFP) while the other Acacia species had a low NFP.

Cowpea, Vigna unguiculata (L.) Walp. presents phenotypical variabilities and in order to study the genetic diversity of cultivated Senegalese varieties, two experimental approaches were used. First, a physiological characterization based on nitrogen fixation was used to assess cowpea breeding lines. Inoculation with two Bradyrhizobium strains (NGR234 and ISRA312), showed a difference in nitrogen fixation potential between the cowpea varieties. Diongoma is the highest nitrogen fixing variety, whereas Mouride is the lowest. The second approach employed genetic characterization based on DNA polymorphism to screen. Results suggest that random amplified polymorphic DNA (RAPD) technology can be used to reorganize the national germplasm in order to eliminate the putative duplicates, and to identify elite varieties. (African Journal of Biotechnology: 2003 2(2): 48-50)

To evaluate the management of patients with prostate cancer in Senegal.We performed a retrospective descriptive study, based on the medical records of patients managed for prostate cancer during a period of six years and a half from January 1, 2004, to June 30, 2010. All records of inpatients and outpatients managed for prostate cancer were collected. Data collection was performed through a standardized survey form, and included the following parameters: age, presence or absence of known history of prostate cancer in siblings, circumstances of discovery, clinical and paraclinical examination, histology and therapeutic modalities.We studied the records of 164 patients with prostate cancer. The mean age of our patients was 65years, ranging from 43 to 96years. The circumstances of diagnosis were mostly due to lower urinary tract symptoms. Digital rectal examination was suggestive in 87% of cases, and PSA levels were high in 100% of cases, ranging from 5.88ng/ml to 21,660ng/ml, with a mean of 1447.57ng/ml. Half of the patients had PSA levels greater than or equal to 100ng/ml. The most common histological type was adenocarcinoma. During the study period, 49 radical prostatectomies were performed. The mean PSA levels of patients who underwent a prostatectomy were 23.4ng/ml. Radical retropubic prostatectomy was performed in 35 patients, and radical perineal prostatectomy was performed in 10 cases. Pulpectomy was the method most commonly used in metastatic prostate cancer; it was performed in 48 patients. After resistance to castration, antiandrogens were reintroduced in 13 patients, and diethylstilbestrol in four patients. Only two patients underwent a taxane-based chemotherapy regimen.The diagnosis of prostate cancer was usually tardive in Senegal. Treatment often involves surgical castration. Prostatectomy was only very seldom indicated.

Authors present 13 cases of spinal neurinomas and neurofibromas out of 418 non- pottic, non-traumatic medullary compression operated between 1965 and 1995. All cases were histologically documented. Neurinomas and neurofibromas represent 3.1% of all non pottic, non traumatic medullary compression and 12.8% of tumour medullary compression operated in our service. The illness started with radicular pains (6 cases) and spinal ache (5 cases) and most of the time, the medullary compression diagnosis is completed at the spasmodic paraplegia status. No patient has done any C.T. scan but in the other hand a myelography has been completed in all cases, resulting in the blockage of the contrast product which in 4 cases was of an epidural type, and in 2 cases of intra dural type. All patients were operated through a posterior approach, which ended in 10 cases to a total removal, and in 3 cases to a partial one. 7 extradural localizations were noticed and 3 neurinomas, 3 neurofibromas and 1 neurofibrosarcoma were histologically identified. A post operative follow-up was done on 11 patients and a satisfactory result was obtained on 6 of them. In 2 cases, the neurological status remained unchanged. In 2 cases a deterioration occurred and a patient with neurofibrosarcoma passed away.

This is the presentation of an adolescent's clinical case who tried to commit suicide with a fire arm during a depressive crisis. An emphasis is placed on the family interaction model and on a more global approach of the patient's personality. The authors underlined some of the problems raised by the diagnostic approach linked to the delirious syndrome, full of psychotic elements: themes of persecution, mystico-religious themes associated with impulsive escapade, all of them going with a depressive state. They gave also an important place to a pluridisciplanary treatment in those particular stages of crisis.

Penetrating spinal cord injuries (P.S.C.I.) are rarely described in Sub Saharian countries in spite of an increasing number of wars. To study epidemiology management and prognosis of P.S.C.I. in Senegal, population of 16 patients collected from Fann Hospital in Dakar has been studied. 9 cases were related on gunshot or shrapnel injuries and 6 were stab-wounded. 8 came from war practice and 7 from civilian practice. The point of entry was at the posterior or lateral part of the body and continuous leaking of cerebral spinal fluid from this point was founded only in one patient. Patients showed a clinical picture of a complete spinal cord section syndrome, 3 spinal cord hemisection Brown Sequard syndromes, 3 cauda equina syndromes and 1 monoradicular syndrome. Spinal X-rays or myelography may lead to an accurate evaluation of the extent of bone tissue destruction. Anatomical evaluation of roots and spinal cord lesions were more difficult when C.T. scan or R.M.I. is not available. Penetrating spinal cord injury with foreign body included or myelography stop or showing cauda equina syndrome should be operated on. 9 of our patients has benefited of spine surgical posterior approach (laminectomy). Immediate vital prognosis is good regarding the fact that visceral associated lesions were rare (2 cases). Functional recovery is fair only 46.6% of patients expressed partial or complete recovery. Prognosis factors such as injuring agent and initial neurological status has been discussed. Prognosis of penetrating spinal cord injuries could be improved by immediate and multidisciplinary management.

Maternal mortality is still too high in sub-Saharan Africa, particularly in referral hospitals. Solutions exist but their implementation is a great issue in the poor-resources settings. The objective of this study is to assess the effect of the organization of obstetric care services on maternal mortality in referral hospitals in Mali.This is a multicentric observational survey in 22 referral hospitals. Clinical data on 42,929 women delivering in the 22 hospitals within the 2007 to 2008 study period were collected. Organization evaluation was based on explicit criteria defined by an expert committee. The effect of the organization on in-hospital mortality adjusted on individual and institutional characteristics was estimated using multi-level logistic regression models.The results show that an optimal organization of obstetric care services based on eight explicit criteria reduced in-hospital maternal mortality by 41% compared with women delivering in a referral hospital with sub-optimal organization defined as non-compliance with at least one of the eight criteria (ORa=0.59; 95% CI=0.34-0.92). Furthermore, local policies that improved financial access to emergency obstetric care had a significant impact on maternal outcome.Criteria for optimal organization include the management of labor and childbirth by qualified personnel, an organization of human resources that allows timely management of obstetric emergencies, routine use of partography for all patients and availability of guidelines for the management of complications. These conditions could be easily implemented in the context of Mali to reduce in-hospital maternal mortality.

During the summer (8 June through 3 September) of 2008, nine ozonesondes are launched from Dakar, Senegal (14.75° N, 17.49° W) to investigate the impact of the Saharan Dust Layer (SAL) on ozone (O3) concentrations in the lower troposphere. Results during June (pre-monsoon period) show a reduction in O3, especially in the 850–700 hPa layer with SAL events. However, O3 concentrations are increased in the 950–900 hPa layer where the peak of the inversion is found and presumably the highest dust concentrations. We use the WRF-CHEM model to explore the causes of elevated O3 concentrations that appear to have a stratospheric contribution. During July and August (monsoon period), with the exception of one SAL outbreak, vertical profiles of O3 are well mixed with concentrations not exceeding 55 ppb between the surface and 550 hPa. In the transition period between 26 June and 2 July lower tropospheric (925–600 hPa) O3 concentrations are likely enhanced by enhanced biogenic NOx emissions from the Saharan desert and Sahelian soils following several rain events on 28 June and 1 July.

Neonatal mortality is a major public health problem. The main causes are infections, prematurity and asphyxia at birth. In view of reducing this high mortality, primary healthcare facilities were equipped with basic equipment for the care of newborns and their key workers were trained in essential newborn care. Three years after this implementation, the present study assesses the state and conditions of use of this basic equipment intended for taking care of newborns at birth.This assessment was conducted from 16 March to 3 April 2009. It was based on observations and interviews on a sample of healthcare facilities.Healthcare facilities were generally equipped with ventilator bags and masks (87%) (60/69). In more than half of the healthcare centers (20/38), they were not used often because the workers were renewed and not educated in their use. They were practically all in good condition. Eighty-five percent (59/69) of healthcare facilities had at least one aspirator, generally adapted to newborns (negative pressure, 100 mmHg). The maintenance of the material was globally satisfactory because the aspirator bottles were most often clean. As for the aspirator tubes, they were always available but a few cases of supply rupture were observed in some healthcare centers. The warming table was available in only 52% (36/69) of healthcare facilities. Fifteen tables did not comply with initial specifications.This assessment highlights that the basic equipment intended for newborn care was generally available, functional and maintained well after 3 years. This strategy could be scaled up in order to contribute to reducing the newborn mortality.

This paper describes the study of low pressure chemical vapour deposition of silicon from disilane (Si2H6) in a horizontal hot-wall furnace. Special attention is devoted to the kinetic phenomena, and in particular to the thickness distribution across the wafers and across the load. Examples are given, which show that acceptable uniformities can be obtained. A simulation of these processes is also presented. For that, a two-dimensional model taking into account, in every region of the furnace, mass transport, fluid dynamics and chemical reactions in the gas phase and on the solid surfaces has been used. In particular, it shows that the much lower deposition rate obtained when silane (Si2H4) is the source gas is due to a much lower silylene (SiH2) contribution. The SiH content measurements by Fourier transform IR spectroscopy show that, for similar deposition conditions (temperature and pressure), the SiH content of “SiH4 films” is much higher than that of “Si2H6 films”, thus confirming than the ultimate silicon precursor is different for the two gases. The study of the crystallization properties of the amorphous films made on SiO2 shows that they are dependent not only on the SiH content, but also on the deposition growth rate and pressure.

We report our experience with 79 intracranial meningiomas operated on between 1960 and 1995 in Dakar Senegal. In our geographical region issues concerning diagnosis, therapy and clinical course are still a topic of debate due mainly to the lack of high-performance technical units. All patients were admitted with evident symptoms. The classically described prevalence was not found in this series. Thirty-one cases presented intracranial hypertension with or without a focal syndrome which evidenced a motor deficit in 32 cases and irritative lesions in 24. External bulging of the meningioma was observed in a large number of cases (11.4%). Until 1994, angiography was the only available means of diagnosis. Mortality was high (30 cases) and results depended on delay to surgery, tumor localization and operative conditions. Our results have been improving over the years but cannot be sustained unless the technical unit is upgraded.

A retrospective study was carried out from January 2000 to December 2003 to assess the resistance of Mycobacterium tuberculosis to antituberculosis drugs and the impact of this on the treatment result. Two hundred and two patients' files were studied (average age: 36 years; sex-ratio: 1.7). Pulmonary localisation (85.7%) or extrapulmonary localisation (14.3%). HIV status is negative (71.3%), positive (10.8%) or unknown (17.9%). The overall recovery rate is 60.7% (61.4% in HIV-; 46.1% in HIV+), the rate of treatment failure is 2.7% (1.1% in HIV-; 15.4% in HIV+), the death rate due to tuberculosis is 6.3% (2.3% in HIV-; 23.1% in HIV+), and the rate of patients who disappeared from the system is 30.3% (35.2% in HIV-; 14.2% in HIV+). Hepatotoxicity that occurred during treatment is observed in 14.3% of cases (recovery: 56.2%; failure: 6.2%; lost from the system: 18.8%). Eighty-four percent of patients never received antituberculosis treatment (group A) versus 15.8% of patients who had already received one or more antituberculosis drugs (group B). The rates of resistance to isoniazid are 6.4% (A) and 12.5% (B), to rifampicin 1.7% (A) and 12.5% (B), to ethambutol 0.5% (A) and 0% (B), to streptomycin 24.1% (A) and 46.8% (B). The percentage of multiresistant strains is 1% in patients not treated previously and 11% in those who had already received antituberculosis treatment. When the patients are carriers of a strain that is responsive to the treatment administered, the recovery rate is 64.2% versus 46.7% in patients whose strain is resistant to at least one of the treatments administered.

In sub-Saharan Africa, problems of access to relevant and high-quality facility-based statistics hinder the assessment of safe motherhood programs. The objective of this study was to assess the quality of data collected in referral hospitals in Mali and Senegal after the routine information system (RIS) was strengthened.This was a multicenter observational study conducted during the pre-intervention period of a randomized controlled trial (trial QUARITE). The RIS was strengthened based on technical, organizational and behavioral factors. We included all women who gave birth in the 46 referral hospitals from October 1, 2007 to October 30, 2008. The completeness, completion and accuracy rates were monitored every 3 months in each hospital. The cost of investment needed to strengthen the existing RIS was also determined.The mean completeness rate ranged from 94 to 97% depending on the study period. The completion and accuracy rates increased during the study period from 72% and 79% to 87% and 93%, respectively (significant differences). The average investment per hospital was less than 1% of state subsidies for public hospitals.Strengthening the existing information system has set up an economically and technologically appropriate system for monitoring maternal and perinatal health in Senegal and Mali. We encourage policy makers and researchers from countries with limited resources to invest in RIS to improve and monitor the performance of health systems.

N fixed in 16 cultivars of cowpea [Vigna unguiculata (L.) Walp] inoculated with effective Bradyrhizobium strains collected from the West African MIRCEN culture collection was measured by 15N isotope dilution technique. In all plant parts, significant differences in the percentage of N derived from the atmosphere (%Ndfa) and the amount of Ndfa occurred between the cultivars. Ndoute variety exhibited the highest %Ndfa (74.33% in shoots; 60.90% in roots) and accumulated more fixed N (960 mg N plant–1 and 38 mg N plant–1 in shoots and roots, respectively). Therefore this cultivar should be selected as the highest N-fixing cowpea cultivar. It also should be used in a breeding programme to contribute to the development of cultivars that could stimulate an intensive use of cowpea in many different cropping systems in Africa with a view to maintaining soil fertility.